The purpose of this investigation is to evaluate the quality and effectiveness of specialized burn patient care at several of the nation's leading Burn Care Facilities and to develop appropriate standards to improve burn patient care throughout the United States. Data from the National Burn Information Exchange (N.B.I.E.) will be utilized. The research design consists of comparisons of burn care institutions with respect to mortality rates and other outcomes, severity of burns treated, procedures for patient care, and other institutional characteristics including demographic profiles of patients. Five interrelated studies are proposed over a five-year period, with the first three of these planned for the first three years for which funding is requested in this proposal. The five studies are (1) a Retrospective Institutional Differences Study utilizing data on current N.B.I.E. participants, (2) an Institutional Review Study which will provide additional data to be incorporated into the first study, (3) a Prospective Institutional Differences Study for which the N.B.I.E. will be extended to cover other specialized burn care facilities, (4) an Extension to Hospitals without Specialized Burn Units, and (5) a Synthesis and Summarization Study. The third study will include the evaluation of feedback to current N.B.I.E. participants after the first study. In addition to leading to recommendations for the care of burn patients, the applicability of the research designs and statistical methodology developed to other emergency medical care systems and problems will be studied.